Objectives: Quality of life (QoL) of patients with chronic kidney disease (CKD) is severely compromised. The association between deteriorating kidney function and anemia is well established. This study assessed the impact of anemia (defined using KDIGO guidelines and/or ESA usage) on QoL in patients with CKD. MethOds: A descriptive, cross-sectional analysis of data derived from an Adelphi CKD-Disease Specific Program, which took place across Europe between June-September 2012, was conducted. Health-related QoL (HRQoL) was assessed via EQ-5D-3L, Kidney Disease and Quality of Life (KDQOL-36) measures, including Short Form-12 (SF-12). Activity impairment data were obtained from the Work Productivity and Activity Impairment questionnaire. Additional data were collected through patient-record forms completed by attending physicians. Results: A total of 1336 patient-completed questionnaires were analyzed from an evaluable population of 2898 patients with CKD (stage 3, 4, and on dialysis). Similar significant and comparable correlations were observed between serum hemoglobin levels and the extent of HRQoL scores. The mean EQ-5D utility value across all patient groups was 0.76, and values were consistently lower for anemic versus non-anemic patients. Scores on the SF-12 physical and mental composite scales, and three additional subscales of the KDQOL-36, also revealed greater impairment in anemic patients. For all patients, the EQ-5D utility value was negatively associated with severity of physician-reported patient tiredness. Activity impairment was higher in anemic versus non-anemic patients with CKD stage 3 (37.5% vs 28.4%), stage 4 (48.1% vs 39.9%), or on dialysis (52.0% vs 45.0%). Anemia appeared to accentuate the disease burden in patients with stage 4 CKD to levels typically associated with dialysis. cOnclusiOns: Disease burden in patients with CKD is driven by anemia, a potentially remediable condition. Longitudinal studies are needed with larger subgroups to rule out possible confounding variables and to understand the true impact of anemia in CKD.